In:
Journal of Bone and Mineral Research, Oxford University Press (OUP), ( 2024-01-04)
Abstract:
Osteoporosis and cardiovascular disease (CVD) are highly prevalent in older women, with increasing evidence for shared risk factors and pathogenesis. Although FRAX was developed for assessment of fracture risk, we hypothesized that it might also provide information on CVD risk. To test the ability of the FRAX tool and FRAX-defined risk factors to predict incident CVD in women undergoing osteoporosis screening with DXA, we performed a retrospective prognostic cohort study which included women aged 50 years or older with a baseline dual-energy X-ray absorptiometry scan (DXA) in the Manitoba Bone Mineral Density (BMD) Registry between March 31, 1999 and March 31, 2018. FRAX scores for major osteoporotic fracture (MOF) were calculated on all participants. Incident MOF and major adverse CV events (MACE; hospitalized acute myocardial infarction [AMI], hospitalized non-hemorrhagic cerebrovascular disease [CVA] , or all-cause death) were ascertained from linkage to population-based healthcare data. The study population comprised 59 696 women (mean age 65.7 ± 9.4 years). Over mean 8.7 years of observation, 6021 (10.1%) had MOF, 12277 women (20.6%) had MACE, 2274 (3.8%) had AMI, 2061 (3.5%) had CVA, 10253 (17.2%) died. MACE rates per 1000 person-years by FRAX risk categories low (10-year predicted MOF & lt;10%), moderate (10–19.9%) and high (≥20%) were 13.5, 34.0 and 64.6, respectively. Although weaker than the association with incident MOF, increasing FRAX quintile was associated with increasing risk for MACE (all p-trend & lt;0.001), even after excluding prior CVD and adjusting for age. HR for MACE per SD increase in FRAX was 1.99 (95%CI 1.96–2.02). All FRAX-defined risk factors (except parental hip fracture and lower body mass index) were independently associated with higher non-death CV events. Although FRAX is intended for fracture risk prediction, it has predictive value for cardiovascular risk.
Type of Medium:
Online Resource
ISSN:
0884-0431
,
1523-4681
DOI:
10.1093/jbmr/zjad010
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2024
detail.hit.zdb_id:
2008867-X
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